Jake Lange, PTA Valid NPI

Individual provider · Physical Therapy Assistant · Branford, CT

NPI

1194350090

Type

Individual (Type 1)

Primary specialty

Physical Therapy Assistant

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225200000X

License number

002006 (CT)

Sex

Male

Sole proprietor

No

Enumerated

2020-03-11

Last updated

2020-03-11